Provider Demographics
NPI:1508102369
Name:HOLBERT, NADIA D'CARLO (PHARM D)
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:D'CARLO
Last Name:HOLBERT
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4611 HARD SCRABBLE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-8584
Mailing Address - Country:US
Mailing Address - Phone:803-736-9599
Mailing Address - Fax:
Practice Address - Street 1:4611 HARD SCRABBLE RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-8584
Practice Address - Country:US
Practice Address - Phone:803-736-9599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC011162183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist